Pharmacy life can be stressful. During the past several years, the profession has seen some changes. Some good, some a little more challenging. Pharmacists being able to give vaccines, for one, was good. Tighter regulations from Health Canada, for another, was stressful for some.
Then of course, there's COVID-19; the biggest healthcare disaster most of us have ever faced. Pharmacists are right on the front lines, and by all accounts, the stress is crushing.
So how are pharmacists coping with COVID-19?
At iApotheca, we talk to a lot a lot of pharmacists; we're all about pharmacy, all day, every day. Our pharmacists work in all sorts of professional settings all over North America. From clinics to mail order pharmacies, chains to small, independent stores.
And things are stressful everywhere.
Stress is not unusual for us as a topic of conversation; it's an underlying theme in pharmacy.
Stress because there’s a huge lineup of patients waiting. Stress because reconciling the narcotics is going to take up valuable time the pharmacy staff doesn't have. Stress from overwork, from dealing with sick and irritable patients, from exhaustion.
Even before COVID-19, pharmacist burnout was happening at higher rates than ever before. But since the start of the COVID-19 crisis, life in the pharmacy has been nothing short of frantic.
What are we hearing?
That it’s the phone calls; non-stop calls with questions or refill requests. Its patients panicking as they try to refill their scripts, only to hear they can’t get more than a 30-day supply. It’s the struggle to get in touch with the doctors’ offices, when some are open, and some aren’t.
It’s the stress of being low on supplies and feeling wedged between wholesalers and the patients.
It’s the nonstop faxes. The long hours.
Add all that to the normal everyday demands that pharmacists face, even without the burden of a worldwide healthcare crisis. The constant distractions, the never-ending to-do list, the multitasking, the compliance issues. The constant stream of patients.
It's no surprise that pharmacists burn out.
What Burnout Feels Like
On the surface, most of us understand what burnout looks like. Irritability, negativity, exhaustion. So why is it so hard to recognize when you've reached that point? Because by the time someone has burned out, their mental clarity is gone.
So how can you tell if you're burned out? It's different for everyone.
For you it may be snapping at your pharmacy staff. Or your patients. Being uncommunicative at home when you manage to get there. And that’s for those pharmacists who can be at home now. Many are staying elsewhere to protect their families from potential exposure to COVID-19.
Burnout can show up as insomnia, a lack of appetite, a feeling of constant harassment and stress.
Burnout when things are normal may mean your patients don’t make you as happy as they once did. During a worldwide disaster, you may find them exhausting.
Oh, and then there's the constant trouble focusing; not good for a pharmacist.
There are so many clues, but it all comes down to one thing: you're not feeling like yourself, and you’re definitely not feeling good.
Some of the most common signs of burnout are:
· Impaired mental acuity such as focus, trouble remembering details and issues concentrating.
· Lack of control over your emotions, which are starting to feel more and more erratic. Perhaps an increase in arguments in your personal and/or work life.
· Anxiety and insomnia; your mind is racing all the time, and you feel like you can’t shut down and relax.
· Overwhelming feelings of negativity and hopelessness. An inability to picture a brighter life in the future or remember why you're a pharmacist in the first place. What were you thinking?
Burnout can cause a wide range of physical symptoms too. Headaches, dizziness, chest pain and shortness of breath. Panic attacks, frequent illness as your immune system struggles to keep up. Stress wreaks havoc on your cortisol levels, increasing inflammation. And of course, there's a lack of interest in food, intimacy, and doing the things you used to love.
The physical signs are not hard to spot if you’ve got the presence of mind to look for them. Which burned out people often don't. For many people who have reached this stage of exhaustion, everything feels hopeless. But its not. There are steps you can take to protect your mental and physical health. And the minute you realize you're suffering from burnout, healing becomes vital.
Neglecting to look after yourself at this stage means risking all sorts of health issues. From full-on chronic fatigue to anxiety disorders, depression, weight gain. And of course, long-term issues like heart disease, diabetes and even cancer.
On the mental health side, things get serious too. Pharmacists have higher rates of both substance abuse and suicide than they should. As a pharmacist, you’ll have a pretty good idea of the potential health risks. Which gives you a head start as far as knowing that you need to deal with the situation.
But how?
You need a plan to manage your own health and wellness. What should that look like? You should be outlining steps to heal yourself from burnout and exhaustion while taking proactive measures against it getting worse.
So, what if taking time off isn’t an option? Many pharmacies are short staffed right now, struggling. You still need a plan to protect your health and wellness, as well as that of your patients. A burned-out pharmacist can make mistakes, and that can be dangerous.
Either way, in putting together your recovery plan, think physical and psychological factors. You also need to understand that this is not something you can take care of on your own. One of the most important aspects of recovery involves getting out of your own head and finding help. It can be tough. Burnout often comes with feelings of isolation.
But there is support available.
Get Professional Help
The first step toward healing from burnout is to get professional help. In the case of concerns about your exposure to COVID-19 it’s obvious; get tested. If you suspect you’re starting to feel run down due to stress, it’s time to kick your wellness into high gear.
The mind-body connection is a powerful thing. And keeping your physical health in order can ease anxiety and motivate you to heal.
Depending on your situation, counseling is important. Having that outlet can make all the difference when you’re struggling to keep things together. Right now, the Canadian Psychological Association is offering free counseling services to front-line healthcare workers.
The Mental Health Commission of Canada has also developed two virtual crisis response training programs for essential workers. The programs focus on awareness around mental health for both you and your team.
And the Centre for Addiction and Mental Health is also providing resources for healthcare workers.
Make no mistake; if you feel like you're juggling the impossible, it's probably because you are. Getting professional advice means getting the support you need as you nurture yourself back to health.
So what are some other ways you can do that?
As a pharmacist, you’re no doubt used to being on your feet all day. Yet burnout is rarely a physical thing. Chances are it’s the psychological stressors on the job that have led to you this point, especially in the middle of COVID-19.
And the stressors build on each other. Yet you’re too busy to sit down and connect with how stressed out you are. How exhausted. In the end, burnout is always about a loss of self-connection, a loss of perspective.
So what does that mean for your self-care strategy?
It means take some time to sit down and think it out. Even if it’s just for ten minutes while you eat lunch. Where are you at in your head right now?
What can you do to keep your head above water? If you were feeling burned out before the start of COVID-19, what were you doing that you shouldn't be doing in the future? Were you ignoring diet and proper nutrition? Neglecting exercise and other forms of self care?
What haven't you been doing that you should? Taking time to sit down for a few minutes every day and connect with yourself? Managing your stress with meditation or a brisk walk every day?
What do you love to do? Figure out how to get more of that in your life. If you can integrate the things you love into your busy life, even in short bursts, you'll be better for it. And in many cases, short bursts are the only option these days.
Keep a Journal
Keeping a journal can be a great way to explore our thoughts and emotions; to connect with yourself. Journaling provides us with clarity around our issues. At the same time, it can keep us accountable to ourselves during the healing process.
Maybe you only get five minutes to journal while taking a quick break at work. If you’re scoffing at the idea of getting time for a break, you need to rethink your priorities; your health is your most valuable asset. Risk your health and you risk everything; it’s worth taking a few minutes.
If you use that few minutes to journal, try to focus on the positive. Think about the things you love about your job. Why did you become a pharmacist in the first place? Do you ever get time to think about that anymore? What are the things you love about your patients? What are the things you love about healthcare?
Journaling is an opportunity to dig deep and work through the journey. If you’re feeling stress and burnout, try to remember; at one time you had a very different perspective on your career.
Instead of keeping you mired in the negativity, writing allows you to take a step back and get clear. What happened to get you to this point? Is it just COVID-19? If so, great! Brainstorm some ideas for nurturing yourself through the crisis.
If you were feeling overworked before the pandemic, what are your thoughts now that things have stepped up even more?
In writing it down, we often find a fresh perspective. And with fresh perspective comes understanding.
Becoming a pharmacist is not something that happened to you by accident. You got where you are by putting a great deal of effort into your schooling and your career.
Which means you were passionate once. Keeping a journal can help you remember why.
Diet and Nutrition
One of the most important aspects of staying healthy is managing our diet and nutrition. More and more, people are aware of the impact diet has on their physical health and state of mind. Yet often when we're under stress, proper nutrition is the first thing to go.
So how are you eating these days?
Are you sticking to healthy meals on a regular schedule? Or are you scarfing back fast food several times a week because you’re too rushed to prepare real food? Are you eating your greens every day, getting enough protein? Or are you surviving on pre-packaged, processed foods guaranteed to make you sick?
Are you drinking enough water?
It makes sense; if you’re struggling just to make it through every day, diet can fall by the wayside. The good news is, it's also one of the easiest ways to get yourself back on track.
So include it in your plan; stock up on fresh fruits and veggies. Pick up some nice lean protein foods and healthy carbs. Or better yet, get it delivered; lots of grocery stores have online pick up and delivery service now, so you can do all your shopping online.
What about cooking?
If you're too busy to cook through the week, take an hour or two for meal prep on a day off. Not only is it healthier, meal prep can be fun and even meditative. Prep your food in silence for some much-needed thinking time. Or throw on a favorite movie to get you out of your head for a while. Make it a solitary experience or get the whole family involved. Whatever you need.
Part of managing your wellness is understanding that at some point you let go of your self care. And there's no time like the present for building healthy habits. Getting the proper amount of nutrition in your diet helps the body manage stress. It soothes you in so many ways, helping you think clearer so you can get back on the road to health.
And most important of all, it's a reminder that you’re worth taking the time for.
Exercise
How’s your exercise these days? If you’re feeling burned out, it may not be where it should be. With COVID-19 shutdowns, exercise has been a bit confusing for everyone. But it’s so important that you figure it out.
Why?
It’s hard to argue that exercise helps manage stress. Study after study has proven it.
Exercise gets those endorphins pumping; it helps improve mood and helps the body let go of the stress of the day. And there's nothing like exercise for improving sleep.
But it also takes time out of our busy schedules. So for people facing burnout, exercise often goes the way of nutrition. Out the window.
It's understandable, of course.
When you’re overworked, stressed out and on the front lines of a worldwide crisis, lack of time is an issue. And a stressful one. But getting some exercise doesn’t need to mean a two-hour ordeal every day. There are lots of ways to get exercise in your day in short, manageable bursts.
Like getting up twenty-minutes earlier in the morning for a quick yoga session. Or taking a 15-minute walk on lunch. A favorite for many people is short HIIT workouts.
What exactly is HIIT? High intensity interval training. Short bursts of intense cardio intervals designed to burn some serious fat. Many HIIT workouts last anywhere from 20 to 30 minutes, which is ideal. Yet studies have shown that you can see benefits on only 7 minutes a day. And for many, there’s no equipment required. Which makes these workouts very popular, especially with those who are pressed for time.
HIIT also has some major mental health benefits as far as anxiety and depression.
But whatever you choose to do, be sure to choose a type of exercise that motivates you. If you can find something you love, it will never be a chore. Don't love yoga? Start your day by putting on some music and dancing for a few minutes!
Picking a mode of exercise that you love will help make it easier to stick to. And as with sticking to a healthy diet, regular exercise reminds you that you're worth taking care of.
Meditation
Meditation as an aspect of wellness is on the rise. Around the globe, there are an estimated 200-500 million meditators. Meditation can mean anything from advanced yogic sleep, or Yoga Nidra (which you probably don’t have time for), to a bit of quiet time over a cup of tea. Best of all, you can tailor your meditation to fit into your crazy schedule.
Why meditate?
Meditation has so many benefits; where do I even start?
First, there's the stress relief, the alleviation of anxiety and depression. There's the calm, the introspection, the perspective; it all adds up to mental clarity. Meditation can also help you feel more focused and energized, ease pain and help with memory. When asked why they meditate, 76% of meditators pointed to their general wellness.
When it comes to burnout, a solid meditation practice is preventative. But if you're already suffering from burnout and you're not meditating yet, you should be.
So what should meditation look like for you?
It can be as simple as sitting down for a quiet cup of soothing, antioxidant-rich tea and thinking things out.
For a more guided experience, there are a variety of meditation apps available. Omvana, for one. Calm and Headspace also come to mind; these apps take you through meditations to clear your head. Some of them can be as short as two to three minutes, which makes them easy to fit in with your busy day.
If you're looking to protect your wellness, meditation is a great tool to have in your arsenal.
Is it Really as Easy as it Sounds?
Many pharmacists were at risk for burnout even before the COVID-19 crisis. Now, with the pandemic in full swing, it's almost a given.
Along with all the previous stressors, pharmacists face a barrage of new responsibilities. Protecting staff, getting ahold of medications to fill scripts. And of course, soothing anxious patients. Not to mention being short staffed due to quarantine needs. After all, there is a constant risk of exposure to COVID-19.
Right now, pharmacists are providing vital healthcare services, and that's so important. But a burned-out pharmacist can be a dangerous pharmacist, too. Burnout can lead to medication error. It can also lead to mistakes that put you further at risk for contracting the virus.
And in the end, it can seriously affect your health and immunity. So even while things are frantic in the pharmacy, your self care must be a priority.
By taking a few minutes a day, even if it's not every day, to stay aware of your needs and to care for them, you can protect yourself from burnout.
Is it as easy as it sounds? Especially in the middle of a pandemic? No, of course not. But you’re worth it.